1. Field of the Invention
The present intention relates to medical tools for general and specific surgery and more particularly to electrocutting/coagulation instruments which also include a cleaning device for the removal of ash formed in use.
2. Description of the Prior Art
Most surgical procedures now use an electrocutting/coagulation instrument. Cutting with an electric blade or laser blade creates irritating smoke, and cuts blood vessels which bleed. This bleeding in turn disturbs its proper action.
Inhaling the smoke is a health hazard similar to that of air pollution and cigarette smoking. Also, with continuing exposure, it has an accumulative detrimental effect on the lungs. Therefore, providing an electrocutting instrument with the ability to remove such smoke health hazard, is an advantage.
Usually, the blood that results from cutting covers the line of the cutting and also impairs the quality of the electrocutting; thus the blood has to be removed before the electrocutting can be continued.
In the course of the cutting or coagulation with an electric (or laser) blade, ash is formed and sticks to the cutting edge of the blade. This ash has to be scraped off to restore the normal function of the instrument. Usually the surgeon has to stop the course of the surgical procedure and clean the tip with another instrument.
Every major surgical procedure in the chest, abdomen (or limbs) includes, as the first stage of the operation, opening the chest or abdominal wall by cutting through its layers. The main instrument used in this stage of the operation is the electrocutting-coagulation scalpel by which the different layers are cut by the main surgeon. The assistant in this stage holds a separate suction apparatus and/or sponges and wipes the blood.
However, the steady increase in time needed for the cutting and/or coagulation, which finally leads to the inevitable arrest of the instrument function, and the inevitable necessity to stop the course of surgery and to clean the instrument, are two major disadvantages of the existing forms of electrocutting blades.
One prior art electrosurgical instrument was that disclosed in U.S. Pat. No. 4,562,838, issued Jan. 7, 1986 to Walker. That patent provided an electrosurgical instrument including a hollow, elongated tube having an inner surface defining an internal longitudinally extending fluid conduit, the tube also having a mounting channel extending longitudinally along the length of the tube. The instrument included an active electrode. The instrument also included a nose piece mounted in the tube and holding the active electrode, the periphery of the nose piece being provided with at least one longitudinal flute which, together with the inner surface of the tube, defined a duct in fluid communication with the remainder of the fluid conduit, the duet being positioned to guide a fluid stream past the active electrode, the nose piece being constructed of an electrically nonconducting material. The instrument also included an electrical lead connected to the active electrode. Finally, the instrument included a light-transmitting cable slidably received within the mounting channel, with the light emitting end of the cable positioned adjacent to the active electrode to illuminate a region around the electrode. This patent did not solve the problem of removing the smoke, but only postponed the solution to the problem by diffusing the smoke into the operating room.
Another prior art electrosurgical instrument was that disclosed in U.S. Pat. No. 4,719,914 issued Jan. 19, 1988 to G. N. Johnson. That electrosurgical instrument included a hollow tubular member having an opening at one end adapted for connection by hollow tubing to a source of vacuum, and a ride opening adjacent to one end. The opposite end of the tubular member included a tapered hollow nose portion. An electrocauterizing blade was secured in, and had one end extending outward from, the end of the nose portion, and had the other end positioned inside the tubular member. Electric heating means were provided for the electrocauterizing blade including an electric lead extending through the tubular member and through the side opening for connection to a power source. The nose portion had a plurality of openings adjacent to the tapered surface thereof adapted to withdraw smoke from a surgical area being cut and cauterized by means of a cam connected to the tubular member open end. Means selectively controlled the application of vacuum through the nose portion openings were provided by means supported on the tubular member for selectively covering and uncovering the nose portion openings. While this patent attempted to use suction to remove smoke, the application of the suction was not at the optimum location with respect to the electrocauterizing blade.
Yet another prior art electrosurgical instrument was the electrocautery surgery apparatus disclosed in U.S. Pat. No. 4,919,129 patented Apr. 24, 1990 by Weber, Jr., et al. That apparatus included an elongated body having an electrical conductor positionable along a slidable path extending substantially therethrough toward a forward end thereof. The apparatus included connector means disposed near the forward end, the connector means being disposed to receive a conductive element therein for selective slidable positioning thereof relative to the forward end in response to slidable movement of the electrical conductor. Slider means were disposed on the body and were coupled to the electrical conductor for selectively altering the position thereof and of the connector means between forward and rearward positions thereof relative to the forward end. Circuit means were disposed in the body to be actuated by the electrical conductor for controlling the application of electrical signal thereto in response to the position of the electrical conductor along the slidable path thereof. The circuit means included an interlock switch operable in both the conductive state and the non-conductive state in response to the electrical conductor being positioned near the rearward position along the slidable path thereof. The interlock switch included auxiliary circuit means disposed in the body for grounding the electrical conductor during operation in the non-conductive state. This patent did not address the problem of the removal of smoke from the area of the electrocautering apparatus.